Officials at Methodist Hospital in Houston cited family privacy on Thursday in declining comment on George H.W. Bush’s condition. The 41st president has been in and out of the hospital since early November battling a severe cough.

As the national government is again mired in hyperpartisan gridlock, remembering the legacy of the elder Bush, and the moderate conservatism that he represented, conjures a striking contrast.

Bush was a transitional figure between the old Republican Party and the new. Two terms after Jerry Falwell and organizations like the Moral Majority delivered the evangelical vote from Carter to Reagan, Christian conservatives were rapidly becoming a powerful Republican voting bloc under Bush, who otherwise represented a Republican party with libertarian, small government roots stretching back to politicians like Barry Goldwater.

The evangelical bloc was, in general, skeptical of Bush, especially in the primary. In many ways, as Steve Kornacki points out in Salon, the primary Republican voters’ reluctance to support Romney in 2012 mirrored their reluctance to support George H.W. Bush in 1980. But Bush faced significantly less opposition in the primaries than Mitt Romney did, testifying to the strengthening political influence that evangelicals have enjoyed over the past few decades; an influence that secured its hold during Bush 41’s administration, despite the president’s mixed record on many of the issues near and dear to the Christian right’s heart.

Bush’s failure to accommodate the Religious Right was felt nowhere more strongly than in his appointments to the Supreme Court. His first appointment, David H. Souter, outraged more extreme conservatives who wanted a conservative replacement for Justice William Brennan, Jr., a liberal leader of the Court. Souter indeed came to vote liberally on issues despite having been appointed by a Republican president.

The Bush presidency, according to legal writer Jeffrey Toobin, was the term in which the Religious Right tried to move from the presidency to the Supreme Court, and thus to their most sacred issues: abortion and expressions of religion in public life. Due to the luck of timing (and a lack of Democratic presidents through much of the seventies through mid-nineties), at the end of the Bush presidency, eight of the nine Supreme Court Justices had been appointed by Republican presidents. But Bush’s presidency also represented the term in which the Religious Right’s influence had been effectively sidelined in the judicial branch: Roe v. Wade, despite Republican presidents pledging to overturn it for evangelical support, never had the votes on the court because of relatively liberal justice appointments from Republican presidents.

George H.W. Bush was the last president who represented the more libertarian, truly small government sentiment that has become a conviction in name only in the mainstream Republican party today. Even his son’s presidency was beholden to the Religious Right, evidenced by his trademark accomplishments like the establishment of the Office of Faith-Based Initiatives, which used government grants to fund church-based charity efforts. The growing influence of Christian groups on the conservative coalition, and later, the Tea Party, would come to mean an inherent paradox within the Republican party: a small-government conviction blemished by attempts to legislate the most intimate aspects of Americans’ lives. George H.W. Bush’s presidency appears to have taken with it the last vestige of Republicans’ former consistency.

As George H.W. Bush’s health continues to be a subject of speculation in the media, it may be time to consider the turning point that his presidency represented for the conservative coalition. Changing demographics and changing stances on abortion, gay marriage, and religion in public life, suggest that the time may be ripe for a revival of a Republican Party without the religious influence that has come to be its feature characteristic. For now, the ailing health of Bush runs parallel to the internal conflicts and existential crises that threaten the core of today’s Republican Party; a profound weakness that suggests a need for serious change.